羟考酮联合舒芬太尼用于老年骨科全麻患者术后自控镇痛的临床研究  

Clinical trial of oxycodone combined with sufentanil for postoperative patient-controlled analgesia in elderly orthopedic patients undergoing general anesthesia

作　　者：罗莹 周慧鹏 李宏 赵鹏 程守全 LUO Ying;ZHOU Hui-peng;LI Hong;ZHAO Peng;CHENG Shou-quan(Department of Anesthesiology,The 964th Hospital,Changchun 130062,Jilin Province,China)

机构地区：[1]第九六四医院麻醉科,吉林长春130062

出　　处：《中国临床药理学杂志》2024年第23期3400-3404,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察羟盐酸考酮注射液联合枸橼酸舒芬太尼注射液自控镇痛对老年骨科全麻患者术后镇静镇痛和谵妄的影响。方法将老年骨科全麻手术患者随机分为对照组和试验组。对照组患者给予2μg·kg^(-1)枸橼酸舒芬太尼注射液+0.075 mg·kg^(-1)盐酸帕洛诺司琼注射液制备静脉自控镇痛(PCIA),试验组患者给予0.2 mg·kg^(-1)盐酸羟考酮注射液+1μg·kg^(-1)枸橼酸舒芬太尼注射液+0.075 mg·kg^(-1)盐酸帕洛诺司琼注射液制备PCIA。比较2组患者不同时刻的镇痛镇静效果、临床指标、血流动力学指标、术后谵妄的发生率,并评价其安全性。结果试验组入组56例,无患者脱落,最终有56例纳入统计分析;对照组入组56例,脱落4例,最终有52例纳入统计分析。试验组和对照组术后24 h Ramsay评分分别为(2.60±0.41)和(2.14±0.35)分,48 h Ramsay评分分别为(2.15±0.27)和(2.00±0.28)分,术后24 h疼痛视觉模拟评分(VAS)分别为(2.21±0.56)和(2.50±0.58)分,术后48 h VAS分别为(1.70±0.47)和(1.94±0.55)分,术后48 h内PCIA给药总量分别为(38.05±10.70)和(50.28±15.87)V·mL^(-1),PCIA按压次数分别为(7.23±1.21)和(8.24±1.50)次,术后24 h平均动脉压(MAP)分别为(95.24±9.30)和(100.54±8.93)mmHg,术后48 h MAP分别为(88.36±8.29)和(92.15±7.36)mmHg,术后1 d的意识模糊评估量表(CAM)评分分别为(19.38±2.00)和(20.29±1.50)分,术后谵妄发生率分别为5.36%(3例/56例)和17.31%(9例/52例),试验组的上述指标与对照组比较,在统计学上差异均有统计学意义(P<0.05,P<0.01)。试验组的药物不良反应主要有恶心呕吐、头晕、寒战,对照组的药物不良反应主要有恶心呕吐和寒战。试验组和对照组的总药物不良反应发生率分别为10.71%(6例/56例)和7.69%(4例/52例),在统计学上差异无统计学意义(P>0.05)。结论盐酸羟考酮注射液联合枸橼酸舒芬太尼注射液比枸橼酸舒芬太尼注射液PCIA用于老年骨科全麻患者术后的镇Objective To observe the effect of oxycodone hydrochloride injection combined with sufentanil citrate injection on sedation,analgesia and postoperative delirium in elderly patients undergoing general anesthesia in orthopedics department.Methods Elderly patients undergoing orthopedic surgery under general anesthesia were divided into the control group and the treatment group by random number classification.Th e c ontrol group was given patient-controlled intravenous analgesia(PCIA)with 2μg·kg^(-1) of sufentanil citrate injection and 0.075 mg·kg^(-1) of palonosetron hydrochloride injection,and the treatment group was given PCIA with 0.2μg·kg^(-1) of oxycodone hydrochloride injection,1μg·kg^(-1) of sufentanil citrate injection and 0.075 mg·kg^(-1) of palonosetron hydrochloride injection.The analgesic and sedative effects at different time points,clinical indicators,hemodynamic indicators,and the incidence of postoperative delirium were compared between the two groups.Safety was evaluated.Results In the treatment group,56 patients were enrolled,and no patients fell off finally,56 patients were included in the statistical analysis.In the control group,56 cases were enrolled,4 cases were lost,and finally 52 cases were included in the statistical analysis.The Ramsay scores of the treatment group and the control group were(2.60±0.41)and(2.14±0.35)points at 24 h after surgery;and the Ramsay scores at 48 h were(2.15±0.27)and(2.00±0.28)points,respectively;the pain visual analogue scale(VAS)at 24 h after surgery were(2.21±0.56)and(2.50±0.58)points;and the VAS at 48 h after surgery were(1.70±0.47)and(1.94±0.55)points,respectively;the total amount of PCIA administration within 48 h after surgery were(38.05±10.70)and(50.28±15.87)V·mL^(-1);the number of PCIA compressions were 7.23±1.21 and 8.24±1.50,respectively;24 h mean arterial pressure(MAP)were(95.24±9.30)and(100.54±8.93)mmHg;and 48 h MAP were(88.36±8.29)and(92.15±7.36)mmHg,respectively;the CAM scores on day 1 after surgery were 19.38±2.00 and 20.29

关 键 词：盐酸羟考酮注射液 枸橼酸舒芬太尼注射液 骨科手术 全身麻醉 镇静镇痛 谵妄 

分 类 号：R971.2[医药卫生—药品]